Drug interactions
Ivosidenib + Quinidine
Severity: Major
Ivosidenib and Quinidine: major interaction.
Last updated Sources: EMA SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs prolong the QT interval, raising the risk of torsades de pointes. Ivosidenib also induces CYP3A4 and may lower quinidine concentrations, which could reduce antiarrhythmic or antimalarial effect.
What this interaction means in plain words
Ivosidenib and Quinidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ivosidenib belongs to Oncology; Quinidine belongs to Anti Parasitic.
Why it happens
Additive QT prolongation plus CYP3A4 induction by ivosidenib, which increases quinidine clearance.
What to do
Avoid the combination or use alternatives. If unavoidable, monitor ECG and electrolytes and monitor quinidine levels and clinical response.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Quinidine?
MediHelp rates the interaction as major. Ivosidenib and Quinidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, raising the risk of torsades de pointes. Ivosidenib also induces CYP3A4 and may lower quinidine concentrations, which could reduce antiarrhythmic or antimalarial effect.
How serious is the interaction between Ivosidenib and Quinidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination or use alternatives. If unavoidable, monitor ECG and electrolytes and monitor quinidine levels and clinical response.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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